Westport Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

2015020290 Issued in MO

Legal business name

WESTPORT DENTAL LLC

Practice address

77 W Port PLZ
Suite No. 251
Saint Louis, MO 63146-3107

Phone

(618) 410-6016

NPI assigned

Mar 26, 2017

Last updated

Mar 26, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adam Birk, D.M.D.NPI 1386050631

Title

Owner

Phone

(618) 410-6016

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adam Birk, DMD

  • Dentist
  • Saint Louis, MO
  • NPI 1386050631
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490486400000",
    "number": "1467983973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9873 GRANTVIEW FOREST DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631233955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W PORT PLZ",
            "address_2": "SUITE NO. 251",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463107",
            "telephone_number": "618-410-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTPORT DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-26",
        "last_updated": "2017-03-26",
        "status": "A",
        "authorized_official_last_name": "BIRK",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-410-6016",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2015020290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinsey Westmoreland
• Ebony Weston
• Westphal-Stolle D.M.D., P.C (Hawthorn Dental, Mehlville)
• Arthur Thomas Westphal, D.M.D.
• Westport Chiropractic and Wellness LLC (WellPro Chiropractic)
• Westport Periodontics P.C.
• Layne Allison Wetherbee
• Darren E Wethers, MD
• Rachel A Wethers, MSW, LCSW
• Karen S Wetmore, MSW LCSW

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.